In the latter half of 2022, many Coloradans became eligible for discounted medical care, thanks to a state legislative bill titled Health Care Billing Requirements for Indigent Patients. This bill established requirements for hospital discounted care for low-income patients. These patients have been given the opportunity to apply for financial assistance or charity care programs at the health care facility where they receive care.
If you are at or below 250% of the Federal Poverty Guidelines (FPG), you are eligible for Hospital Discounted Care. It limits the amounts you can be billed for health care services at hospitals and emergency rooms to rates set by the Department of Health Care Policy and Financing (DHCPF). It also limits amounts billed to you from providers who work at hospitals and emergency rooms. Hospitals must give you the chance to apply for discounted care when you receive services at the hospital.
Who qualifies for discounted medical care in Colorado?
If you qualify, the hospital must also offer you a payment plan based on your income. Payment plans for hospital bills for patients who qualify cannot be more than 4% of your gross monthly income. Payment plans for each provider that bills you separately from the hospital cannot be more than 2% of your gross monthly household income. Payment plans cannot be longer than 36 months of payments. And after you’ve made 36 payments, the bill is considered paid in full. The legislation also set rules for hospitals to limit collections against a patient.
Here are examples of the approximate income limits for who qualifies for Hospital Discounted Care:
|Family Size||Approximate Annual Income||Approximate Monthly Income|
|1||up to $33,975||up to $2,831|
|2||up to $45,775||up to $3,814|
|3||up to $57,575||up to $4,798|
|4||up to $69,375||up to $5,781|
|5||up to $81,175||up to $6,764|
|6||up to $92,975||up to $7,747|
|7||up to $104,775||up to $8,731|
|8||up to $116,575||up to $9,714|
Checking for eligibility for discounted medical care in Colorado
Under the law, you have the right to check to see if you qualify for discounted care or for public health care coverage. You can ask the hospital to help you see if you qualify or you can check the DHCPF website at https://hcpf.colorado.gov/colorado-hospital-discounted-care. If you do not have any health insurance, the hospital is required to see if you are eligible for any of the following public health and discount programs: Health First Colorado (Colorado’s Medicaid), Child Health Plus (CHP+), Emergency Medicaid, Colorado Indigent Care Program (CICP), and hospital discounts.
Even if you have health insurance, you have the right to have your eligibility checked for discounts, but you may have to take the initiative to ask for this check. Then the hospital must check to see if you qualify within 45 days of when you received the service or when you asked to be screened for eligibility. You can refuse to be screened, but if you do you may lose your right to take legal action against the hospital and providers for not screening you for eligibility and/or for not giving you discounts.
Provisions with regard to medical bill collection in Colorado
Under this same law, before sending your bill to collections, a hospital or a provider who works at the hospital and bills you must give you a payment plan if you are eligible and explain all the services and fees on your bill in your primary language. They must bill your insurance if you have it. If it comes to it, they must notify you they may send you to collections.
If you do not agree with a decision about your billing status, you can ask for your case to be reviewed or otherwise appeal the decision. You have 30 days from the date the hospital gave you the decision to file an appeal. Find more information on how to appeal at https://hcpf.colorado.gov/hospital-discounted-care or call 1-800-221-3943.
Complaints for matters involving discounted medical care in Colorado
You can file a complaint if you feel that any of your rights have not been met. Complaints can be filed with the hospital or provider, or they can be filed with DHCPF. For the latter contact 303-866-2580 or visit hcpf_HospDiscountCare@state.co.us.
Informing you of your rights for discounted medical care in Colorado
One final item. Health care facilities must make available a Patient’s Rights form describing this Health Care Discount program to the public and to each patient or each patient’s legal guardian. This includes posting the Spanish and English versions of the form conspicuously on the facility’s website. The form should also be available in the patient waiting areas. Any billing statement should inform each patient or the patient’s legal guardian of the patient’s rights, including the right to apply for discounted care, and provide the website, email address, and telephone number where the information may be obtained in the patient’s preferred language.
For yet more details about discounted medical care in Colorado . . .
If you have additional questions about the Hospital Discounted Care program, especially if they focus on specific details of how the program works, you can very likely find an answer in the listing of Frequently Asked Questions available at Hospital Discounted Care Frequently Asked Questions.